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The pharmacodynamics of torsemide in patients with congestive heart failure
Author(s) -
Vargo Dennis,
Kramer William G,
Black Paula K,
Smith William B,
Serpas Tina,
Brater D Craig
Publication year - 1994
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1994.100
Subject(s) - heart failure , pharmacodynamics , medicine , cardiology , pharmacology , pharmacokinetics
The pharmacodynamics of torsemide (a new loop diuretic of the pyridine sulfonylurea class) was studied in 16 subjects who had compensated congestive heart failure and had been receiving stable diuretic therapy. Oral doses of 50, 100, and 200 mg were studied by use of a randomized crossover design. The results of this study show that the pharmacokinetics of torsemide is linear up to at least a dose of 200 mg in patients with congestive heart failure. Approximately 20% of each of the three doses was excreted unchanged, consistent with previous findings in healthy volunteers. A hyperbolic relationship between diuretic effect and drug excretion rate was defined. The maximum urinary sodium excretion rate attained was about 0.6 mEq/min, which is about 20% of that in healthy subjects, indicating diuretic resistance in these patients. Although there was no saturation of the urinary excretory pathway with doses as high as 200 mg, the upper plateau of the dose‐response curve was reached with doses of 50 mg, indicating that this dose represents a ceiling dose in patients with New York Heart Association class II and III congestive heart failure. Clinical Pharmacology and Therapeutics (1994) 56, 48–54; doi: 10.1038/clpt.1994.100